Spontaneous pneumomediastinum is the presence of interstitial air in the mediastinal structures without an apparent cause. Pneumorrhachis is defined as the presence of air in the spinal canal. Concurrent pneumorrhachis is an extremely rare epiphenomenon of spontaneous pneumomediastinum without pneumothorax. Diagnosis is confirmed by radiologic imaging of the chest. Spontaneous pneumomediastinum and pneumorrhachis usually resolve with conservative therapy such as bed rest, analgesic agents, and supplemental oxygen. A 20-year-old male patient presented with recurrent spontaneous pneumomediastinum with concurrent pneumorrhachis with a gap of 1 year between the two episodes. Pneumomediastinum and pneumorrhachis resolved with conservative management in both episodes.
<p>Rheumatic mitral stenosis is prevalent in the developing world and presents with a wide array of manifestations. Aphonia and hoarseness of voice secondary to recurrent laryngeal nerve paralysis (Ortner’s syndrome) is an uncommon manifestation of mitral stenosis. We present a case severe mitral stenosis with moderate to severe tricuspid valve regurgitation and severe pulmonary artery hypertension that was masquerading as aphonia and hoarseness of voice for eight months. Mitral valve replacement and tricuspid annuloplasty was done and the quality of voice improved post-surgery. </p>
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